In May 2023, the Chinese Stomatological Association promulgated the group standard of "Standard on Clinical Dental Treatment for Children under General Anesthesia Orsedation". These specifications were formulated through broad-based expert consultation, iterative revisions, and a comprehensive review of relevant literature, incorporating the collective expertise of nationally recognized authorities in the field. The standard establishes a unified evaluation system and clinical guidelines tailored to China's medical context, aiming to regulate related medical practices. This paper aims to provide an in-depth interpretation of the standard, integrating the clinical research and experiences from the Pediatric Dentistry Department of West China Hospital of Stomatology, Sichuan University, in performing dental treatments under general anesthesia in last 12 years. It particularly focuses on interpreting key aspects, including safety considerations, treatment protocol selection, prevention and management of postoperative complication, postoperative follow-up, and oral health maintenance, to provide a reference for medical staffs to understand and apply them in clinical practice.
Humans ; Anesthesia, General ; Child ; Dental Care for Children/standards* ; China ; Postoperative Complications/prevention & control* ; Anesthesia, Dental/standards* ; Practice Guidelines as Topic

Objective: To investigate the effects of long-term hyperglycemia on renal pathology of type 1 diabetic mellitus(T1DM) cynomolgus monkeys by establishing streptozotocin(STZ)-induced T1DM. Methods: Eight 4-year-old male cynomolgus monkeys were randomly divided into control and model groups. Four cynomolgus monkeys were used in the control group, and four cynomolgus monkeys were injected with streptozotocin to create a T1DM model. Hematoxylin-eosin(HE) staining and periodic acid-Schiff(PAS) staining were used to observe renal pathological changes.The histological characteristics and changes were observed under transmission electron microscope. Morphometric measurements were used to analyze the glomerular area, the thickness of the glomerular basement membrane, the proportion of glomerular podocyte foot processes and the average area of foot processes. Results: In comparison to the control group, the model group showed pathological changes in the kidneys, including increased glomerular area(P<0.01), thickened basement membrane, capillary loop compression, disordered arrangement of endothelial cell fenestrations, proliferation of mesangial cells, mesangial expansion, accumulation of mesangial matrix glycoproteins, a decrease in the number of foot processes(P<0.001), a decrease in the average size of the foot processes(P<0.05), widened podocyte slit diaphragm, and an increase in the number of fused foot processes(P<0.001). Conclusion Cynomolgus monkeys with T1DM suffer from renal pathological changes due to long-term hyperglycemia.

Objective To investigate the clinical characteristics and prognosis of crown fractures in immature per-manent incisors due to trauma,and identify factors affecting their prognosisto provide a reference for clinical treatment.Methods This study was approved by the Medical Ethics Committee of West China Stomatology Hospital,Sichuan University.The study subjects were patients admitted to the pediatric stomatology department from December 2011 to December 2021,and a retrospective analysis was conducted on young permanent teeth with anterior crown fracture caused by injury and followed up for at least 1 year,which were diagnosed as enamel fractures,enamel-dentin fractures,and complicated crown fracture and treated by observation,pulpotomy etc.in the first appointment.The age,sex and time elapsed from trauma to baseline visit of the patients and the location,mobility,stage of root development,diagnosis and treatments were collected.The occurrence of pulp infection,pulp necrosis,and other events in the affected tooth is defined as clinical failure.Record whether clinical failure occurred and the timing of their occurrence of the traumatized tooth.Analyze factors related to the prognosis of various types of crown fractures in young permanent incisors and per-formsurvival analysis on the affected teeth.Results Among 358 cases of young permanent incisors,50 cases were diag-nosed with enamel fracture,176 cases with enamel-dentin fracture,and 132 cases with complicated crown fracture.The clinical success rate of crown fractures was 73.7%(264/358)in young permanent incisors.The incidence rates of clini-cal failure cases,including pulp infection and necrosis,were 4%(2/50)for enamel fractures,33.3%(58/176)for enamel-dentin fractures,and 25.8%(34/132)for complicated crown fractures respectively.The clinical failure rate of enamel-dentin fracture treated with indirect pulp capping and restoration was higher than restoration only and pulpotomy(χ2=10.077,P=0.004).The clinical failure rate of complicated crown fractures treated with direct pulp capping was higher than pulpotomy(χ2=5.501,P=0.038).The clinical failure rates between observation,smoothing edges and restoration of enamel fractures exhibit no significant differences(χ2=0.588,P=0.999).Risk factors for clinical failure in this study population included patient age over 9 years old(HR=2.11,95%CI:1.1-3.9,P=0.017)、time elapsed from trau-ma to baseline visit greater than 3 days(HR=2.3,95%CI:1-4.8,P=0.028),traumatized teeth with mobility(HR=1.95,95%CI:1.2-3,P=0.004),enamel-dentin fractures treated with restoration(HR=6.89,95%CI:1.6-29.6,P=0.010),enamel-dentin fractures treated with indirect pulp capping and restoration(HR=13.8,95%CI:3.2-58.3,P＜0.001)and complicated crown fractures treated with direct pulp capping(HR=46.07,95%CI:8-263.8,P＜0.001).Conclusion Enamel fractures treated by observation,smoothing edges and restoration,and complicated crown frac-tures treated with pulpotomy generally had a good prognosis in young permanent incisors.Close follow-up was recom-mended for crown fractures in young permanent incisors with identified risk factors for poor prognosis.

Objective We aimed to investigate the effects of electroacupuncture at"Zusanli"(ST36)and"Taichong"(LR3)on gastrointestinal motility,gastrointestinal hormones,and brain-gut axis in rats with functional dyspepsia(FD).Methods 48 SD rats were randomly divided into a normal control group,a model group,a cisapride group,and an electroacupuncture group,with 12 rats in each group.A mild tail pinch stimulation combined with intermittent food deprivation was used to establish the FD rat model.Body mass,food intake,and sucrose preference rate were recorded before and after modeling to verify the success of the FD model.After modeling,the normal control group and the model group received no intervention;the cisapride group rats were administered cisapride[0.4 g/(kg·d)]by intragastric perfusion for 6 consecutive days as one course of treatment,with a rest day between each course;the electroacupuncture group rats received electroacupuncture stimulation at bilateral"Zusanli"and"Taichong"(DC,dense-sparse wave,2/100 Hz,2-5 mA.Electricity was applied for 30 min),with stimulation every 24 h for 6 consecutive times as one course of treatment,with a rest day between each course.After two courses of treatment,samples were collected to compare gastrointestinal motility indices,blood levels of gastrointestinal hormones[motilin,gastrin,serotonin(5-HT),nitric oxide(NO)],serum and tissue levels of endogenous brain-gut peptides[cholecystokinin(CCK),calcitonin gene-related peptide(CGRP),neuropeptide Y(NPY)]in the hypothalamus,gastric antrum,duodenum,colon,and protein expressions of ghrelin and substance P in the hypothalamus,spinal cord,gastric antrum,and colon.Results Body mass,food intake,and sucrose preference rate were lower of the model rats than those of the normal rats(P<0.05).Compared with the model group,rats in the electroacupuncture group and cisapride group had(i)lower gastric residual rates,higher rates of small intestinal propulsion and gastric slow wave main frequency and power(P<0.05);(ii)levels of motilin,gastrin,and 5-HT increased,while NO level decreased(P<0.05);(iii)serum CCK content increased,while CGRP and NPY levels decreased(P<0.05);(iv)CCK protein positive expression increased,while CGRP and NPY protein positive expression decreased in the hypothalamus,gastric antrum,duodenum(P<0.05);(v)ghrelin protein expressions increased,and substance P protein expression decreased in the hypothalamus,spinal cord,gastric antrum,and colon(P<0.05).There were no significant differences in these indicators between the electroacupuncture group and the cisapride group.Conclusion Electroacupuncture at"Zusanli"and"Taichong"can effectively alleviate gastrointestinal motility disorders in FD rats,regulate gastrointestinal hormone levels,reverse abnormal brain-gut peptide expression,and regulate brain-gut interaction balance.

Objective:To explore whether acupuncture can affect intestinal barrier and visceral pain of rats with irritable bowel syndrome(IBS)by regulating brain-derived neurotrophic factor(BDNF)and its downstream tyrosine kinase receptor B(TrkB),and to explore the possibility of BDNF/TrkB signaling pathway as a new target for acupuncture treatment.Methods:Sixty SD rats were ran-domly grouped into healthy group,IBS group,acupuncture group,positive control group and acupuncture+TrkB activation group,with 12 rats in each group.An IBS rat model was established,abdominal withdrawal reflex(AWR)was used to detect visceral pain of rats in each group;levels of TNF-α and IL-1β in colon of rats in each group were measured;expression levels of colonic mucosal cyto-plasmic Claudin 1(ZO-1)and occludin were measured with immunohistochemistry;expression levels of BDNF and TrkB mRNA and protein in colon of rats in each group were measured with fluorescence quantitative PCR and Western blot.Results:Compared with healthy group,colonic mucosa of rats in IBS group was damaged,expressions of ZO-1 and occludin were significantly reduced,AWR score,fecal water content,TNF-α and IL-1β contents,colonic BDNF,TrkB mRNA and BDNF protein expressions,and TrkB phos-phorylation were significantly increased(P<0.05);compared with IBS group,colon mucosa of acupuncture group and positive control group gradually recovered,expressions of ZO-1 and occludin were significantly increased,AWR score,fecal water content,TNF-α and IL-1β contents,colonic BDNF,TrkB mRNA and BDNF protein expressions,and TrkB phosphorylation were significantly re-duced(P<0.05);compared with acupuncture group,colonic mucosa of rats in acupuncture+TrkB activation group still had lesions,expressions of ZO-1 and occludin were significantly reduced,AWR score,fecal water content,TNF-α and IL-1β contents,colonic BDNF,TrkB mRNA and BDNF protein expressions,and TrkB phosphorylation were significantly increased(P<0.05).Conclusion:Acupuncture can regulate BDNF/TrkB pathway,inhibit expression of related proteins,improve intestinal barrier function,reduce vis-ceral pain,inflammation and relieve IBS.

Objective:To establish a graded method to avoid mean fluorescence intensity(MFI)threshold of HLA Class I antibodies corresponding antigen,and the HLAMatchmaker program has been used to select the minimum mismatch value of donor-patient epitopes.Evaluate the application value of combining both methods in selecting HLA compatible platelets(PTL)for patients with immune platelet transfusion failure(IPTR)in improving platelet the corrected count increment(CCI).Methods:A total 7 807 PLT cross-matching compatible were performed by the solid-phase red cell adherence(SPRCA)method for 51 IPTR patients.The Luminex single antigen flow cytometry was used to detect HLA Class I antibodies in patients,and detected the MFI value for different specificity antigens of HLA Class I antibodies,was graded into strong positive group(MFI＞4 000,level 1),medium positive group(1 000＜MFI 4 000,2),weak positive group(500＜MFI≤1 000,3),and one negative control group(MFI≤500).The results of 7 807 SPRCA their negative/positive reaction wells were enrolled and statistically analyzed in different grades and the four groups,the statistical differences between the four groups were compared.Multiple applications for the select HLA Class I compatible donor events were made for patients in two cases,and HLAMatchmaker program was used to calculate the number of HLA Class I epitopes mismatches between the donors and patients.The donor with the minimum number of epitopes mismatches was selected,while avoiding the corresponding antigens of HLA Class I antibodies in levels 1 and 2,the provision of HLA compatible platelets for IPTR.After the transfusions,the CCI value of the platelet transfusion efficacy evaluation index was calculated,and the clinical evaluation of the transfusion effect was obtained through statistical analysis.Results:There were statistically significant differences in the positive results of SPRCA immunoassay among the strong positive group,medium positive group,and weak positive group of 51 IPTR patients with different specific of HLA-I class antibodies and corresponding antigens(all P＜0.001).The positive results showed a range from high to low,with strong positive group＞medium positive group＞weak positive group.There were a statistical difference among between the strongly positive or moderately positive groups and the negative control group(P＜0.001).There was no statistical difference between the weakly positive group and the negative control group(P＞0.05).The strong positive group was set as the corresponding specific HLA Class I site corresponding antigen grade 1 avoidance threshold,the medium positive group as the grade 2 avoidance thresholds,and the weak positive group as the grade 3 avoidance threshold.In the case of donor platelet shortage,it is not necessary to avoid the weak positive group.Avoiding the strategy of donor antigens and HLAMatchmaker program scores≤7 corresponding to HLA Class I antibodies of levels 1 and 2,with CCI values＞4.5 × 109/L within 24 hours,can obtain effective clinical platelet transfusion conclusions.Conclusion:When selecting HLA Class I compatible donors for IPTR patients,the grading avoids HLA Class I antibodies corresponding to donor antigens,and the donor selection strategy with the minimum scores of HLAMatchmaker program is comprehensively selected.The negative result confirmed by platelet cross-matching experiments has certain practical application value for improving platelet count in IPTR patients.

Aim To elucidate the mechanism by which Rg3 regulates the function of CD8

OBJECTIVE To study the improvement effects of Shangke xiaoyan hydrogel plaster on osteoarthritis （OA） model rats. METHODS Rats were randomly divided into blank group， model group， voltaren group （200 mg/rat）， Shangke xiaoyan ointment group （500 mg/rat， containing Shangke xiaoyan fluid extract 50 mg） and Shangke xiaoyan hydrogel plaster group （200 mg/rat， containing Shangke xiaoyan fluid extract 50 mg）， with 8 rats in each group. Except for blank group， OA model was established in the other groups by injecting papain and L-cysteine into the right knee joint cavity of the rats； they applied the corresponding drugs， and changed the dressing once a day， for 14 consecutive days. The degree of knee joint swelling in rats was detected， and the magnetic resonance imaging characteristics of the knee joint in rats were observed； the levels of interleukin 1β （IL-1β）， IL-6， IL-18 and tumor necrosis factor （TNF- α） in rat serum were detected； the pathological and morphological characteristics of knee joint tissue were observed， and the histopathological and cartilage Mankin scores were performed； the protein expressions of IL-1β， IL-6 and TNF-α in knee joint tissue were all detected. RESULTS Compared with blank group， severe joint swelling， obvious joint effusion and patchy wear of the anterior horn of the lateral meniscus were observed in model group； the serum levels of IL-1β， IL-6， IL-18 and TNF- α and histopathological score and Mankin score were significantly increased （P＜0.05）； protein expressions of IL-1β， IL-6 and TNF-α in knee joint tissue were increased. Compared with model group， the knee swelling degree of the rats in Shangke xiaoyan hydrogel plaster group was reduced， a small amount 　　 of joint cavity effusion could be seen， and the shape of the meniscus was completely normal； the histopathological score E-mail：frankyan@cpu.edu.cn and Mankin score were significantly reduced （P＜0.05）levels of inflammatory factors in serum were reduced （P＜0.05） and those of knee tissue were decreased. CONCLUSIONS Shangke xiaoyan hydrogel plaster can improve OA of rats， the mechanism of which may be associated with reducing the levels of inflammatory factors in joint and serum.

Poria is an important medicine for inducing diuresis to drain dampness from the middle energizer. However, the specific effective components and the potential mechanism of Poria remain largely unknown. To identify the effective components and the mechanism of Poria water extract (PWE) to treat dampness stagnancy due to spleen deficiency syndrome (DSSD), a rat model of DSSD was established through weight-loaded forced swimming, intragastric ice-water stimulation, humid living environment, and alternate-day fasting for 21 days. After 14 days of treatment with PWE, the results indicated that PWE increased fecal moisture percentage, urine output, D-xylose level and weight; amylase, albumin, and total protein levels; and the swimming time of rats with DSSD to different extents. Eleven highly related components were screened out using the spectrum-effect relationship and LC-MS. Mechanistic studies revealed that PWE significantly increased the expression of serum motilin (MTL), gastrin (GAS), ADCY5/6, p-PKAα/β/γ cat, and phosphorylated cAMP-response element binding protein in the stomach, and AQP3 expression in the colon. Moreover, it decreased the levels of serum ADH, the expression of AQP3 and AQP4 in the stomach, AQP1 and AQP3 in the duodenum, and AQP4 in the colon. PWE induced diuresis to drain dampness in rats with DSSD. Eleven main effective components were identified in PWE. They exerted therapeutic effect by regulating the AC-cAMP-AQP signaling pathway in the stomach, MTL and GAS levels in the serum, AQP1 and AQP3 expression in the duodenum, and AQP3 and AQP4 expression in the colon.
Animals ; Rats ; Poria ; Spleen ; Albumins ; Chromatography, Liquid ; Cyclic AMP Response Element-Binding Protein

Aim To explore whether sea-buckthorn slows down-regulation of hepatic cytochrome P450 2C(CYP 2C)in mice with liver injury by BCG vaccine(BCG)-induced via PXR/NF-κB pathway.Methods The mouse model of liver injury was induced by a single tail vein injection of BCG 125 mg·kg-1 for hepatitis B research,and the mice were randomly di-vided into control group,BCG group,BCG+sea-buckthorn granules(SG)group(gavage 50,100,200 mg·kg-1,twice a day),BCG+PCN group(intraper-itoneal injection 100 mg·kg-1,once a day).The levels of serum transaminase and TNF-α and IL-1β in liver tissue were detected by ELISA.The nuclear pro-tein expression NF-κB p65 and the total protein expres-sion of pregnane X receptor(PXR),CYP2C in liver were detected by Western blot.Liver pathological changes were observed by HE staining.Results Sea-buckthorn inhibited overexpression of TNF-α,IL-1βand NF-κB p65,alleviated the down-regulation of CYP2C and PXR protein expression,and improved liv-er pathology and serum transaminase in a dose-depend-ent manner.After intervention with PCN,a mouse specific agonist of PXR,it was similar to the high dose group of SG.Conclusion Sea-buckthorn slows down-regulation of CYP2C in mice with liver injury by BCG-induced via PXR/NF-κB pathway.